Day: February 9, 2021

Categories : PaediatricsTags :

Caffeine Shown to Alter Brain Pathways in Utero

On By ModernMedia

Caffeine consumption during pregnancy could change key brain pathways, resulting in children having significant behavioural problems in later life. 

“These are sort of small effects and it’s not causing horrendous psychiatric conditions, but it is causing minimal but noticeable behavioural issues that should make us consider long term effects of caffeine intake during pregnancy,” said John Foxe, PhD, director of the Del Monte Institute for Neuroscience. “I suppose the outcome of this study will be a recommendation that any caffeine during pregnancy is probably not such a good idea.” Foxe also pointed out that this was a retrospective study, reliant on mothers’ recall of caffeine consumption.

Studies had already linked caffeine to other outcomes, such as a meta-review which found a nearly linear link between caffeine consumption and low birth weight. It is known that foetuses do not possess the enzyme necessary to break down caffeine, which crosses the placenta into the foetal bloodstream.

Researchers at the Del Monte Institute for Neuroscience at the University of Rochester Medical Center (URMC) analysed brain scans of thousands of children. The researchers observed increased behavioural and attention problems along with hyperactivity in these children. They observed distinct changes in how the white matter tracks (which connect brain regions) were organised in children of mothers who reported caffeine consumption during pregnancy.

“What makes this unique is that we have a biological pathway that looks different when you consume caffeine through pregnancy,” said first author Zachary Christensen, an MD/PhD candidate in the Medical Science Training Program. “Previous studies have shown that children perform differently on IQ tests, or they have different psychopathology, but that could also be related to demographics, so it’s hard to parse that out until you have something like a biomarker. This gives us a place to start future research to try to learn exactly when the change is occurring in the brain.”

At this stage it is not known what the relationship between amounts of caffeine are, or what effects arise in each trimester.

“Current clinical guidelines already suggest limiting caffeine intake during pregnancy—no more than two normal cups of coffee a day,” added Christensen. “In the long term, we hope to develop better guidance for mothers, but in the meantime, they should ask their doctor as concerns arise.”

Source: Medical Xpress

Journal information: Zachary P. Christensen et al, Caffeine exposure in utero is associated with structural brain alterations and deleterious neurocognitive outcomes in 9–10 year old children, Neuropharmacology (2021). DOI: 10.1016/j.neuropharm.2021.108479

Categories : Diseases, Syndromes and ConditionsTags :

Treating Periodontitis can Reduce Risks of Certain Other Diseases

On By ModernMedia

A steadily growing body of evidence points to a two-way connection between oral health and systemic disease.

Periodontitis, the inflammation and disease of tissues surrounding the teeth, is already known to be a result of type 2 diabetes, but there is research to suggest that it may also cause diabetes—as well as certain other diseases.

“What happens in your body impacts your mouth, and that in turn impacts your body. It’s truly a cycle of life,” said Professor Purnima Kumar of The Ohio State University. “What is more dynamic than the gateway to your body – the mouth?” she continued. “It’s so ignored when you think about it, and it’s the most forward-facing part of your body that interfaces with the environment, and it’s connected to this entire tubing system. And yet we study everything but the mouth.”

The link between oral health and type 2 diabetes was first established in the 1990s, and Prof Kumar has led many investigations into this area. She was lead author in a study published last year that investigated the oral microbiomes of people with and without type 2 diabetes, and the effects of nonsurgical periodontitis treatment.

“Our studies have led up to the conclusion that people with diabetes have a different microbiome from people who are not diabetic,” Prof Kumar said. “We know that changing the bacteria in your mouth and restoring them back to what your body knows as healthy and friendly bacteria actually improves your glycemic control.”

The rough picture that has emerged is that oral bacteria are aerobic, but even small changes such as a few days of not brushing teeth can trigger a cascade that results in the bacteria shifting to an anaerobic, fermentative state producing toxins and byproducts. It becomes, as Prof Kumar puts it, “a septic tank” that stimulates the immune system and causes an inflammatory state, producing signalling products that bacteria then feed on.

“Then this community – it’s an ecosystem – shifts. Organisms that can break down protein start growing more, and organisms that can breathe in an oxygen-starved environment grow. The bacterial profile and, more importantly, the function of the immune system changes,” she explained.

The inflammation causes pores to open in the lining of the mouth, allowing the bacteria entry to the body.

“The body is producing inflammation in response to these bacteria, and those inflammatory products are also moving to the bloodstream, so now you’re getting hammered twice. Your body is trying to protect you and turning against itself,” Prof Kumar said. “And these pathogens are having a field day, crossing boundaries they were never supposed to cross.”

Though the relationship between oral health and certain disease is a complex one, Prof Kumar said prevention was exceedingly simple. Daily brushing and flossing with twice-yearly dentist visits for cleaning were sufficient.

Source: News-Medical.Net

Journal information: Kumar, P. S., et al. (2020) Subgingival Host-Microbial Interactions in Hyperglycemic Individuals. Journal of Dental Research. doi.org/10.1177/0022034520906842. 

Categories : Ageing General Interest Neurodegenerative DiseasesTags :

Legendary Singer Tony Bennett Diagnosed with Alzheimer’s

On By ModernMedia

Music legend Tony Bennett, 94, revealed in an interview that he was diagnosed with Alzheimer’s disease 4 years ago.

The singer’s career has spanned seven decades, he had continued his initial success in the 1950s across multiple genres, becoming a hit with the MTv generation, and in more recent years collaborating with popular artists like Amy Winehouse and Lady Gaga.

Alzheimer’s disease is an age-related, irreversible neurodegenerative condition. In more than 90% of patients, it begins after age 65, although it can occur as early as in the 30s. It is marked by memory loss and confusion that seem like the normal cognitive decline of older age, but it is more rapid and severe, eventually resulting in death. As people live longer and the risks of developing this disease increase with age, the burden of this disease is expected to increase in the future. In the US, the number of people with Alzheimer’s is expected to nearly triple from 5.5 million to 14 million by 2060.

Mr Bennett has been able to work over the past four years but the toll is perceptible. He still recognises his family members but his short-term and long-term memory have drastically deteriorated. Interviewer John Colapinto noted Mr Bennett gazing at his lavishly illustrated book, “Tony Bennett Onstage and in the Studio” (2018). “He stared into its pages not with the air of warm reminiscence but like a man struggling to recall why these images seemed familiar.” His wife, Susan, added that Mr Bennett is “not always sure where he is or what is happening around him. Mundane objects as familiar as a fork or a set of house keys can be utterly mysterious to him.”

Over the past two years, Mr Bennett recorded a second album of duets with Lady Gaga, a follow-up to the hit album with Gaga in 2014. While he had been known to be a “meticulous and hard-driving perfectionist in the studio,” Mr Bennett was much more subdued. speaking rarely, his words coming haltingly and seeming lost or bewildered. Gaga, who considers Mr Bennett to be “an incredible mentor, and friend, and father figure” is seen breaking down in tears as Tony sings a solo passage of a love song.

The album is due to be released this spring, but Mr Bennett will be unable to do promotional interviews. Mr Bennett, together with his wife and son (who is also his manager) decided to break the news, in the hopes that as many fans as possible know about what will likely be his final record. The neurologist who diagnosed Bennett in 2016,  Gayatri Devi, MD, said: “He is doing so many things, at 94, that many people without dementia cannot do. He really is the symbol of hope for someone with a cognitive disorder.”

Source: MedPage Today

Categories : COVIDTags :

SARS-CoV-2 Mutation Evolved in Immunocompromised Patient

On By ModernMedia

The discovery of SARS-CoV-2 mutations evolving in an immunocompromised patient treated with convalescent plasma has been revealed by Ravindra Gupta, MD, PhD, of University of Cambridge in England, and team.

“We have documented a repeated evolutionary response by SARS-CoV-2 in the presence of antibody therapy during the course of a persistent infection in an immunocompromised host,” the authors wrote.

Previous research has shown that immunosuppressed patients could serve as reservoirs for norovirus variants.

Although they did not claim the UK variant was created by that particular case, Gupta’s group speculated that the plasma therapy could have unleashed the resistant variants, and could do so in other immunosuppressed patients too.

They wrote that, in such patients, “the antibodies administered [in plasma] have little support from cytotoxic T cells, thereby reducing chances of clearance and theoretically raising the potential for escape mutations.” 

They cautioned that convalescent plasma use should be limited, and only with appropriate infection control in monitoring in immunosuppressed patients.

A man in his 70s, who had received immunotoxic chemotherapy to treat lymphoma eight years previously, was initially hospitalised in May with neutropenic sepsis, and, about a week later, tested positive for SARS-CoV-2. He was discharged later in May, but in late June was readmitted with cough and breathlessness.

His condition worsened and he received dexamethasone and two 10-day courses of remdesivir 5 days apart. On two days around July 20, convalescent plasma was administered; more remdesivir and convalescent plasma was administered about 4 weeks later. He died shortly afterward.

Gupta and team took viral samples from this patient on 23 occasions, and over the first 57 days, they observed little change in viral population upon treatment with remdesivir, but after the July round of convalescent plasma, a shift in viral genotype occurred.

Initially the patient’s viral serotype showed a mutation first reported in China. However, in late July, a variant was observed with two alterations in the spike protein, including the deletion seen in the B.1.1.7 variant. Testing showed a twofold reduced susceptibility to the antibodies in the convalescent plasma.

The team wrote that this sort of evolution is unlikely to emerge in immunocompetent patients. They cautioned against using convalescent plasma in severe COVID patients, and especially those who were immunosuppressed.

The study’s limitations included being only a single case, and samples were taken from the upper respiratory tract and not the lower respiratory tract. 
Given South Africa’s large HIV positive population, if viral evolution is driven by convalescent plasma in immunosuppressed patients, this raises questions for the country’s COVID strategy.

Source: MedPage Today

Journal information: Kemp SA, et al “SARS-CoV-2 evolution during treatment of chronic infection” Nature 2021; DOI: 10.1038/s41586-021-03291-y.

Categories : COVIDTags :

As COVID Variants Dominate, Better Mask Use is Needed

On By ModernMedia

Evidence is accumulating that COVID is commonly transmitted through small aerosolised droplets emitted during regular speaking and breathing—a problem compounded by the enhanced contagiousness of variants such as 501Y.V2, the strain which dominates in South Africa.

Masks have become ubiquitous in the pandemic-struck world, and even fashionable, with many different types available. However, their effectiveness varies considerably from top-of-the-range N95 masks to a pulled-up shirt which offers very little protection.
“How well a mask works depends on two things: filtration and fit,” said Professor Linsey Marr, who studies airborne disease transmission at Virginia Tech .

“Good filtration removes as many particles as possible, and a good fit means that there are no leaks around the sides of your mask, where air—and viruses—can leak through,” she said, noting that even a small gap could result in a 50% reduction in effectiveness.

We do not recommend wearing more than two masks. Adding more layers proves diminishing returns and can compromise breathability. It must remain easy to breathe through the layers; otherwise, air is more likely to leak in around the sides of the mask.

Wearing a cloth mask over a surgical mask, or ‘double masking’ does improve effectiveness as it serves to tighten the surgical mask’s fit. Air escapes around the corners and edges of the mask, as anyone who has worn glasses and had them fog up in the cold can attest to.

While N95 masks are the best available, there are also equivalents such as KN95 or FFP2.

“They all provide a similar level of filtration, meaning protection of particles going in and out,” said Ranu Dhillon, a global health physician at Brigham and Women’s Hospital and Harvard Medical School. Dhillon is frustrated at the lack of transparency and education for the public about masks.

Health care workers, for example, get their masks tested for fit, something which could be also done by members of the public.

Donald Milton, a professor of environmental health at the University of Maryland, said that the key to understanding the COVID airborne transmission threat is to treat it like cigarette smoke. Ventilation helps, but if you have someone between you and an exhaust vent, then masks will definitely help.

Before the pandemic, Milton and Dhillon courted controversy by demonstrating that most viral transmission was in the form of small droplets emitted when speaking or breathing, and the contribution to transmission by coughing and sneezing was smaller than previously thought. The two researchers are hopeful that their findings will find their way into official COVID policy, and future research may even see masks becoming a common sight during peak flu seasons.

Source: Japan Times

Categories : Medical Research & TechnologyTags :

New Type of Sensor ‘Bandage’ Alerts Clinicians to Pressure Sores

On By ModernMedia

A new type of wearable sensor ‘bandage’ that can monitor blood oxygenation is being developed.

Driven partly by the growing interest in telemedicine as a result of COVID researchers at Missouri S&T are working on a printable, flexible, disposable sensor that can interact with a smartphone. This new kind of inexpensive sensor could alert health care workers early on to developing conditions such as pressure ulcers. Pressure ulcers normally develop from ischaemia caused by pressure and shear, and often occur in hospitalised patients or bedridden patients at home.

“Our current work focuses on designing and optimising a tissue oxygen sensor by using inexpensive inkjet printing techniques,” said Dr Chang-Soo Kim, professor of electrical and computer engineering at Missouri S&T. “Concurrently, we are developing a smartphone app that can interpret sensor images. This prototype will be evaluated using phantom tissue that mimics a pressure ulcer site.”

Dr Kim is working with other researchers to create a cheap, easy-to-use sensor to help prevent pressure sores which are on the rise due to obesity and diabetes. This might speed recovery, reducing the length of hospital stays and saving millions of dollars. 

Current pressure ulcer monitoring involves manual examination, but with this wearable sensor, drops in oxygen levels are sensed at the at-risk site before they have a chance to turn into a sore. The change could even be detected at home, in say a foot ulcer, alerting a clinician via smartphone who could then provide a diagnosis. 

“Our optical sensor bandage functions by detecting a low skin oxygen level caused by compromised circulation,” said Kim. “This low oxygen produces a color change called luminescence intensity. The smartphone can then take a photograph of the dressing and transmit it to enable remote monitoring or encourage timely intervention before major skin decomposition occurs.”

Source: Medical Xpress